Journal articles on the topic 'Hidradenitis suppurativa (HS)'
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1
Khojah, Abrar F., and Yousif A. Qari. "Hidradenitis Suppurativa and Crohn’s Disease:." Saudi Journal of Internal Medicine 6, no. 2 (December 31, 2016): 47–52. http://dx.doi.org/10.32790/sjim.2016.6.2.7.
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Hidradenitis suppurativa is a rare chronic / recurrent, infl ammatory and suppurative disease that affects apocrine gland-bearing areas of the skin, including the axillae, inframammary fold, inguinal and anogenital regions. Few reports have described the co-occurrence of Hidradenitis suppurativa and Crohn’s disease and the challenge in managing patients with both conditions. We describe two cases in which HS developed during the course of Crohn’s disease in one patient, while it preceded the onset of Crohn’s disease in the other case. Both patients showed poor response to biological therapy although one case initially responded well to induction therapy with infliximab.
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De Felice, Bruna, Concetta Montanino, Marta Mallardo, Graziella Babino, Edi Mattera, Giovanni Ragozzino, Giuseppe Argenziano, Aurora Daniele, and Ersilia Nigro. "Circulating microRNAs in Hidradenitis Suppurativa." Genes 13, no. 9 (August 26, 2022): 1544. http://dx.doi.org/10.3390/genes13091544.
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Hidradenitis suppurativa (HS) is a pathology characterized by chronic inflammation and skin lesions. The molecular basis of the inflammatory network remains unclear; however, since microRNAs (miRNAs) are involved in the modulation of inflammation, the composition of a micro-transcriptome RNA library using the blood of HS patients was analysed here. The total miRNA expression profiles of miRNAs from HS patients was assayed by real-time qPCR. Here, compared to healthy controls, miR-24-1-5p, miR-146a-5p, miR26a-5p, miR-206, miR338-3p, and miR-338-5p expression was found significantly different in HS. Knowing the significance of the miRNA mechanism in inflammatory and immune progression, we suggest that miRNA profiles found in HS patients can be significant in understanding the pathogenesis modality and establishing efficient biomarkers for HS early diagnosis. In particular, miR-338-5p was closely related to HS invasiveness and production of cytokines and was atypically overexpressed. miR-338-5p may represent a good promise as a non-invasive clinical biomarker for HS.
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Maclean, Gael M., and David J. Coleman. "Three Fatal Cases of Squamous Cell Carcinoma Arising in Chronic Perineal Hidradenitis Suppurativa." Annals of The Royal College of Surgeons of England 89, no. 7 (October 2007): 709–12. http://dx.doi.org/10.1308/003588407x209392.
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INTRODUCTION Hidradenitis suppurativa (HS) is a chronic, inflammatory and suppurative disorder of skin bearing apocrine glands. The most severe complication is squamous cell carcinoma (SCC) and we here present three cases, all of which proved fatal, and review the past 40 years of published cases. PATIENTS AND METHODS Three advanced cases of SCC arising in chronic HS have been referred for reconstructive surgery over the past 8 years. Another 28 cases published over the past 40 years were identified using a Medline search (search items in combination: hidradenitis, squamous, carcinoma). RESULTS The male:female ratio was 4:1, most (61%) were perineal or buttock. We found no reports of SCC arising in axillary disease. The symptomatic history of HS prior to SCC diagnosis ranged from 3–50 years with a mean of 25 years. Age at diagnosis of SCC ranged from 27–71 years, and 15 patients (48%) died within 2 years of SCC diagnosis. CONCLUSIONS We advocate that hidradenitis suppurativa arising in extra-axillary sites is a pre-malignant condition, and should not be treated conservatively; curative resection is the mainstay of management.
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Spaskova, Vaska. "HIDRADENITIS SUPPURATIVA." MEDIS – International Journal of Medical Sciences and Research 1, no. 2 (May 31, 2022): 43–47. http://dx.doi.org/10.35120/medisij010243s.
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Hidradenitis suppurativa (HS), or still known under the name Acne Inversa is a multifactor disease that has a chronic flow and starts with the capture of follicles of fibers located in intertriginous regions or anogenital regions. It is followed by recurrent, deep, sub connected and painful nodes, connected intertriginous sinus tracts and hypertrophic scars. Women are more versatile from men, according to 3:1 and more likely to develop axillary and genitofemoral lesions than a male population that develops changes that are localized in the perineal region. The disease itself is unpredictable flow and cannot be certain whether the period of menstruation, pregnancy or menopause may affect the deterioration of the patient’s condition. Usually, the bacterial infection that builds on the state itself is like a secondary phenomenon and most often isolate beta hemolytic streptococcus or staphylococcus. The pathogenesis of the disease is still unclear, but it is thought that the primary event that occurs is follicular occlusion occurring as a result of infundibular keratosis and epithelial hyperplasia. Features show that patients say that the same changes occur in other members of the family. Some genes from Secretase G family are thought to be responsible for the disease itself. On the other hand, there are autoimmune reasons for the very disease, both of the innate and the acquired immunity. However, this disease is classified as neutrophilic restriction. The simplest and most widely used instrument for HS classification in routine clinical practice. It classifies HS into three stages: Stage I: isolated, single or more painful abscesses, no scars and occurrence of cicatrix. Stage II: recurrent pain abscesses with scars, single or multiple but not so extensive. Stage III: diffuse, similar to plates, inflammatory, sick infiltrates or more mutual abscesses. Contracts of joints as a result of limited mobility associated with pain. Because the disease has more stages and treatment itself will be correlated with the stage of the disease. We should emphasize that the disease can also be worsened by some accompanying diseases from which the type 2 diabetes or some other endocrine and metabolic diseases should be distinguished in the first place. Always put the lifestyle and change in everyday habits as it is in the first place to reduce weight if it is increased as well as the cancellation of cigarette smoking. Primary in treatment is maintaining good personal hygiene with soaps that are antibacterial and pastures with mild disinfection. At the beginning of the disease, antibiotics are usually attached as local and systemic administration, most often from the group of tetracyclines. Anti-inflammatory preparations are given in order to reduce inflammation and drug reduction drugs. As antiseptics use salicylic solution, alcohol pine, camphor, ethyl alcohol or iodine. More recently, it goes to make drinks from iodine and potassium hypermangan. If it is not contraindicated, corticosteroid creams and gels as well as a local anesthetic can be reduced. Surgical intervention can be applied to make an incision of a nodule or an apex to be easier drainage and thus reduced the pain of the region concerned. It should be noted that this disease affects the whole family. In the first place, it is necessary to accept the patient’s patient in order not to isolate it from the rest and to participate in social life as before the disease itself. A conversation is necessary by a psychologist with the whole family in order to facilitate life and improve the quality of it.
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Kiss, Norbert, Dóra Plázár, Kende Lőrincz, András Bánvölgyi, Sándor Valent, and Norbert Wikonkál. "A hidradenitis suppurativa nőgyógyászati vonatkozásai." Orvosi Hetilap 160, no. 8 (February 2019): 291–99. http://dx.doi.org/10.1556/650.2019.31319.
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Abstract: Hidradenitis suppurativa is a chronic inflammatory disease of the hair follicles, usually presenting after puberty on the apocrine gland-bearing areas of the body. It usually flares up periodically and can lead to a severe condition affecting the 20–40-year-old childbearing age group. HS occurs more commonly in women. The main clinical features consist of painful, cicatrizing nodules and abscesses which develop mostly in the axillary, inguinal, genital and perianal regions and also on the breasts. HS is often accompanied by severe pain and malodorous discharge, both of which cause significant psychological stress and social stigma. Our main aim with this review paper is to highlight the gynecological aspects of this disease, as many times – due to the typical localization of the disease – patients seek gynecological care first when they experience the first symptoms of this disease. The most important classification of HS is the Hurley scale, which is based on the severity of the clinical symptoms. In recent years, numerous clinical trials have been conducted to seek optimized care of HS patients. Several drugs are used for the treatment of HS, but in most cases, the treatment has to be switched many times. It is of great importance to carefully follow comorbidities and possible pregnancies as in these cases, careful selection of treatment is required. Thus, HS is not only a dermatological, but also a gynecological disease. With an appropriate treatment and follow-up, the disease can be effectively handled. Orv Hetil. 2019; 160(8): 291–299.
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Kinyó, Ágnes, and Norbert Wikonkál. "New therapeutic approaches in hidradenitis suppurativa." Bőrgyógyászati és Venerológiai Szemle 97, no. 5 (October 29, 2021): 259–64. http://dx.doi.org/10.7188/bvsz.2021.97.5.4.
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Complex multifactorial pathogenesis of hidradenitis suppurativa eventually results in chronic inflammation of the apocrine gland-bearing areas of the skin. However, the pathogenesis is not fully understood, there are many immune cells and inflammatory pathways of which role is clearly defined in the last years in HS, such as interleukin 1β (IL-1β), tumour necrosis factor alpha (TNFα), IL-17, IL-12 and IL-23. These pathways provide multiple targets for medical treatment. Currently, only adalimumab is licenced in HS, but the numerous ongoing clinical trials promise huge potential therapeutic options in this debilitating disease.
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Włodarek, Katarzyna, Aleksandra Stefaniak, Łukasz Matusiak, and Jacek C. Szepietowski. "Could Residents Adequately Assess the Severity of Hidradenitis Suppurativa? Interrater and Intrarater Reliability Assessment of Major Scoring Systems." Dermatology 236, no. 1 (September 5, 2019): 8–14. http://dx.doi.org/10.1159/000501771.
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A wide variety of assessment tools have been proposed for hidradenitis suppurativa (HS) until now, but none of them meets the criteria for an ideal score. Because there is no gold standard scoring system, the choice of the measure instrument depends on the purpose of use and even on the physician’s experience in the subject of HS. The aim of this study was to assess the intrarater and interrater reliability of 6 scoring systems commonly used for grading severity of HS: the Hurley Staging System, the Refined Hurley Staging, the Hidradenitis Suppurativa Severity Score System (IHS4), the Hidradenitis Suppurativa Severity Index (HSSI), the Sartorius Hidradenitis Suppurativa Score and the Hidradenitis Suppurativa Physician’s Global Assessment Scale (HS-PGA). On the scoring day, 9 HS patients underwent a physical examination and disease severity assessment by a group of 16 dermatology residents using all evaluated instruments. Then, intrarater reliability was calculated using intraclass correlation coefficient (ICC), and interrater variability was evaluated using the coefficient of variation (CV). In all 6 scorings the ICCs were >0.75, indicating high intrarater reliability of all presented scales. The study has also demonstrated moderate agreement between raters in most of the evaluated measure instruments. The most reproducible methods, according to CVs, seem to be the Hurley staging, IHS4, and HSSI. None of the 6 evaluated scoring systems showed a significant advantage over the other when comparing ICCs, and all the instruments seem to be very reliable methods. The interrater reliability was usually good, but the most repeatable results between researchers were obtained for the easiest scales, including Hurley scoring, IHS4 and HSSI.
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Makrantonaki, Evgenia. "Hidradenitis suppurativa: Systemische Inflammation als Ursache berücksichtigen." Kompass Dermatologie 5, no. 3 (2017): 146–47. http://dx.doi.org/10.1159/000475562.
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Hintergrund: Hidradenitis suppurativa (HS) ist eine chronisch-entzündliche Hauterkrankung. Die Evidenzlage spricht zunehmend dafür, dass dysfunktionelle Immunreaktionen sowohl der adaptiven als auch der angeborenen Immunität an HS beteiligt sind. Die kürzlich postulierte Assoziation der HS mit dem metabolischen Syndrom könnte zusätzlich zum Entzündungsgeschehen bei HS beitragen. Ziel: Untersuchung des Entzündungsstatus und des Leukozytenprofils im peripheren Blut von HS-Patienten. Material und Methoden: In einer komparativ aufgebauten Querschnittstudie untersuchten wir hochsensitives C-reaktives Protein (hs-CRP) und das Leukozytenprofil in Blutproben von stationär behandelten HS-Patienten (HS-HOSP), laut Selbstauskunft an HS leidenden Patienten aus der Allgemeinbevölkerung (HS-POP) sowie Populationskontrollen. Ergebnisse: Unsere Studie umfasste 32 Personen in der HS-HOSP-Gruppe, 430 in der HS-POP-Gruppe und 20 780 Kontrollen. Der mediane hs-CRP-Wert betrug in der HS-HOSP Gruppe 5,1 mg/l (Quartilsabstand 2,6-8,2), in der HS-POP-Gruppe 2,2 mg/l (1,0-4,3) und bei den Kontrollen 1,3 mg/l (0,7-2,9). Eine nach Lebensalter und Geschlecht adjustierte Analyse ergab ei- nen signifikant höheren hs-CRP-Wert für beide HS-Gruppen im Vergleich zur Kontrollgruppe (p < 0,0001). In der nach Alter und Geschlecht adjustierten Analyse war in beiden HS-Gruppen die Wahrscheinlichkeit einer Leukozytose im Vergleich zur Kontrolle signifikant erhöht; die Odds Ratio lag für die HS-HOSP-Gruppe bei 4,38 (95-%-KI = 2,18-8,80; p < 0,0001) und für die HS-POP-Gruppe bei 1,95 (95-%-KI = 1,58-2,42; p < 0,0001). Das nach Lebensalter und Geschlecht adjustierte Leukozyten-Differentialblutbild ergab signifikant höhere Werte für neutrophile Granulozyten (p < 0,0001) und Monozyten (p = 0,0014; p = 0,0004) in den HS-Gruppen im Vergleich zu den Kontrollen. Schlussfolgerung: Die mit HS assoziierten hs-CRP-Werte scheinen im intermediären Bereich zu liegen (2,2-5,1 mg/l), was eher auf eine systemische Inflammation als auf eine Infektion hindeutet. Bei der Leukozytose im peripheren Blut bei HS standen neutrophile Granulozyten und Monozyten im Mittelpunkt.
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Corazza, Monica, Alessandro Borghi, Vincenzo Bettoli, Roberto Pora, Ilaria Bononi, Elisa Mazzoni, Elisa Mazzola, Silva Saraceni, Martina Maritati, and Carlo Contini. "Irrelevance of Panton-Valentine leukocidin in hidradenitis suppurativa: results from a pilot, observational study." European Journal of Clinical Microbiology & Infectious Diseases 40, no. 1 (August 7, 2020): 77–83. http://dx.doi.org/10.1007/s10096-020-04002-7.
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AbstractPanton-Valentine leukocidin (PVL) appears to be a virulence factor which, among others, can exacerbate the pathogenicity of Staphylococcus aureus infections, especially inducing severe necrotic, deep-seated skin infections, abscesses, and recurrences. These peculiarities have some overlaps with hidradenitis suppurativa (HS). Our main aim was to assess if S. aureus producing PVL could have some role in influencing clinical features and/or course of HS, specifically in the suppuration and recurrence of lesions. This pilot, mono-centric, observational study included all adult subjects affected with HS consecutively referring to our HS clinic over a 3-month period. Clinically evident suppuration and at least 2 weeks wash out from any antibiotic were the main inclusion criteria. Purulent material from HS skin lesions was collected with swabs in order to isolate micro-organisms, with specific regard to S. aureus. Detection of PVL was performed by real-time quantitative PCR (RT-qPCR). We also analyzed purulent material from suppurative skin lesions other than HS, as a control. Thirty HS patients were included; 29 purulent lesions (96.7%) harbored at least one bacterial species. Five (16.7%) swab samples were positive for S. aureus, none of which was positive for PVL genes. Among the 30 purulent disorders included as controls, 8 (26.3%) were positive for S. aureus; of these, 4 strains (50%) expressed LPV. The study results seem to exclude the pathogenetic involvement of S. aureus producing PVL in HS; as a result, PVL does not seem to represent a potential target in the future development of HS treatments.
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Maillard, Alexia, Damien Pastor, and Rastine Merat. "Anti-PD-1-Induced Hidradenitis Suppurativa." Dermatopathology 8, no. 1 (February 25, 2021): 37–39. http://dx.doi.org/10.3390/dermatopathology8010007.
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Mucocutaneous adverse events are commonly observed under immune checkpoint inhibitors (ICIs) therapy. Here, we report the case of a 43-year-old male patient with a stage IIIC melanoma disease who developed hidradenitis suppurativa (HS) three months after the beginning of an anti-PD-1 (nivolumab) adjuvant therapy. The patient had no comorbidities other than obesity and severe acne during adolescence. After an unsuccessful course of lymecycline while he was still treated with nivolumab, he gradually improved under zinc gluconate therapy and, more importantly, after nivolumab cessation. HS is a recurrent follicular inflammatory disease in the apocrine gland-bearing areas of the body often associated with obesity, metabolic syndrome, tobacco smoking, inflammatory bowel diseases, psoriasis, and arthritis. In our patient, the latency period between drug initiation and onset of HS symptoms and the improvement after immunotherapy discontinuation, argued strongly in favor of an anti-PD-1-induced HS. Anti-PD-1 therapies often trigger T cells-mediated adverse events that mimic Th17-mediated inflammatory and neutrophilic diseases. We suggest that HS, as other pustular skin reactions and ICIs-induced neutrophilic colitis, can be part of the anti-PD-1 mucocutaneous adverse event spectrum.
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Shukla, Ratnakar, Priyanka Karagaiah, Anant Patil, Katherine Farnbach, Alex G. Ortega-Loayza, Thrasivoulos Tzellos, Jacek C. Szepietowski, et al. "Surgical Treatment in Hidradenitis Suppurativa." Journal of Clinical Medicine 11, no. 9 (April 21, 2022): 2311. http://dx.doi.org/10.3390/jcm11092311.
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Hidradenitis suppurativa (HS) is a chronic, progressive inflammatory disorder of follicular occlusion with pubertal onset that presents as painful inflammatory nodules, sinus tracts, and tunnelling in apocrine-gland-rich areas, such as the axilla, groin, lower back, and buttocks. The disease course is complicated by contractures, keloids, and immobility and is often associated with a low quality of life. It is considered a disorder of follicular occlusion with secondary inflammation, though the exact cause is not known. Management can often be unsatisfactory and challenging due to the chronic nature of the disease and its adverse impact on the quality of life. A multidisciplinary approach is key to prompt optimal disease control. The early stages can be managed with medical treatment, but the advanced stages most likely require surgical intervention. Various surgical options are available, depending upon disease severity and patient preference. In this review an evidence-based outline of surgical options for the treatment of HS are discussed. Case reports, case series, cohort studies, case-control studies, and Randomized Clinical Trials (RCT)s available in medical databases regarding surgical options used in the treatment of HS were considered for the review presented in a narrative manner in this article.
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Constantinou, Costas A., George E. Fragoulis, and Elena Nikiphorou. "Hidradenitis suppurativa: infection, autoimmunity, or both?" Therapeutic Advances in Musculoskeletal Disease 11 (January 2019): 1759720X1989548. http://dx.doi.org/10.1177/1759720x19895488.
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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease mainly affecting areas rich in apocrine glands. Clinically, is characterized by painful subcutaneous nodules and if left untreated to pus secretion, abscess and fistula formation. Its frequency is estimated to be 0.5–4% of the general population, affecting women more often. Pathogenesis of HS is still not clearly defined. It seems to be a combination of genetic factors with alterations in the skin microbiome. Furthermore, at tissue (i.e. skin) as well as at serum level, several inflammatory cytokines are upregulated. The most important of the latter are tumor necrosis factor (TNF), interleukin (IL)-1, IL-17, and IL-23. Adding another level of complexity, it has been suggested that keratinocytes might be intrinsically activated, contributing also to the observed inflammation. Interestingly, it has been noted that frequency of HS is increased in some autoimmune rheumatic diseases, such as spondyloarthropathies (SpA). Of note, both HS and SpA have relatively strong association with metabolic diseases and obesity implying that there are indeed some common underlying pathophysiological pathways. Although no specific microbe has been identified, alterations in the microbiome of the skin of these patients have been reported. Of note, microbes with a capability for biofilm formation are abundant. Treatment of HS among others, include antibiotics as well as biologic drugs targeting TNF and other cytokines and used for autoimmune rheumatic diseases. Herein, we review the current evidence on links between HS and autoimmune diseases and infectious diseases with a focus on epidemiology and pathophysiology.
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Crowley, Erika L., Ashley O’Toole, and Melinda J. Gooderham. "Hidradenitis suppurativa with SAPHO syndrome maintained effectively with adalimumab, methotrexate, and intralesional corticosteroid injections." SAGE Open Medical Case Reports 6 (January 1, 2018): 2050313X1877872. http://dx.doi.org/10.1177/2050313x18778723.
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Introduction: Hidradenitis suppurativa and synovitis, acne, pustulosis, hyperostosis, osteitis syndrome are chronic, debilitating diseases involving apocrine gland-bearing skin inflammation and bone inflammation, respectively. Although both often present with multiple comorbidities, single patient co-presentation is rare. Methods/Results: This study reports the 8-year treatment course of a 40-year-old man with hidradenitis suppurativa and synovitis, acne, pustulosis, hyperostosis, osteitis syndrome, and reviews relevant literature. Initial oral and topical antibiotics had little effect. Intralesional corticosteroid injections were effective for localized inflammatory lesions but insufficient for hidradenitis suppurativa control. Adalimumab initiation and local excision of a persistent HS lesion led to stabilization. Adalimumab provided dramatic back pain improvement. Synovitis, acne, pustulosis, hyperostosis, osteitis was diagnosed; adalimumab continuation with subsequent methotrexate addition resulted in hidradenitis suppurativa-synovitis, acne, pustulosis, hyperostosis, osteitis control. Conclusions: Literature regarding comorbid hidradenitis suppurativa and synovitis, acne, pustulosis, hyperostosis, osteitis syndrome therapy is scarce but growing. Adalimumab, methotrexate, intralesional corticosteroid, and lifestyle changes successfully maintained a severe hidradenitis suppurativa–synovitis, acne, pustulosis, hyperostosis, osteitis–syndrome case. Further studies beyond a case-based review could yield more definitive treatment plans.
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Guillem, Philippe, Hélène Raynal, Anaïs Wendling, and Nicolas Kluger. "Hidradenitis Suppurativa Influences Tattooing Practice in Women." Dermatology 236, no. 5 (2020): 445–51. http://dx.doi.org/10.1159/000504436.
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Background: The reasons or the motivations that compel people to get a tattoo or a body piercing (BP) are plentiful and personal. Patients with chronic cutaneous or systemic conditions may be interested in getting tattooed or pierced. Objective: To determine the frequency of body art practices in hidradenitis suppurativa (HS) and to evaluate the possible impact of HS in the decision-making process. Methods: An anonymous specific paper-based questionnaire was prospectively offered to patients (≥18 years) consecutively managed for HS from September 2016 to March 2017 in a French specialized center. Results: In total, 209 patients participated in the study, of whom 77 (37%) and 50 (24%) had tattoos and BP, respectively. These proportions were higher than those reported in the French population. HS prevented the decision to get a BP or a tattoo in 2 and 5%, respectively (fear of infection or healing difficulties). Fifteen patients (7%) got tattooed to hide a surgical HS scar (n = 5, 2%), to regain control over the pain or their bodies (n = 9, 4%), or to turn others’ eyes away from HS lesions or scars (n = 1, 0.5%). HS severity influenced a proportion of patients who intended to get a new tattoo. Conclusion: HS is associated with a significant increase in body art practices.
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Alavi, Afsaneh, Eran Shavit, Jeannine Archer, and Christian Pagnoux. "Hidradenitis suppurativa and vasculitis: A case series and literature review of a rare association." SAGE Open Medical Case Reports 7 (January 2019): 2050313X1988285. http://dx.doi.org/10.1177/2050313x19882852.
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Hidradenitis suppurativa is a chronic inflammatory skin disease with dysregulation of the immune system. Its pathophysiology is not clear, and it has been reported in association with various inflammatory disorders such as pyoderma gangrenosum, arthritis, familial Mediterranean fever and inflammatory bowel diseases. However, the co-existence of HS and vasculitis is exceptional and has not been investigated. We report on five patients with vasculitis that are followed in our centers: one with Takayasu’s arteritis, three with granulomatosis with polyangiitis and one with Behcet’s disease and compare them with those previously reported in the literature. A case series and literature review with key words of “vasculitis,” “hidradenitis suppurativa,” and “acne inversa” found only one previous report of hidradenitis suppurativa and cutaneous vasculitis and two with Behcet’s disease. Whereas the association of pyoderma gangrenosum and vasculitis is well-known, that with hidradenitis suppurativa is rarer. There may be some pathogenic continuum between hidradenitis suppurativa, pyoderma gangrenosum and vasculitis.
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Makrantonaki, Evgenia. "Hidradenitis suppurativa: Infektion, Autoimmunkrankheit oder beides?" Kompass Dermatologie 8, no. 3 (2020): 109–10. http://dx.doi.org/10.1159/000509475.
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Hidradenitis suppurativa (HS) ist eine chronisch entzündliche Hautkrankheit, die vorwiegend an Hautarealen auftritt, die viele apokrine Drüsen aufweisen, unter anderem im axillären, inguinalen, genitalen, und submammären Bereich. Die Prävalenz von HS zeigt eine signifikante Variabilität in epidemiologischen Studien und liegt zwischen 0,03% und 4%. Die Erkrankung tritt häufiger bei Frauen als bei Männern auf, Männer-Frauen Ratio 1:2 bis 1:5. Das durchschnittliche Alter bei Erstmanifestation liegt bei 23 Jahren [<xref ref-type="bibr" rid="ref1">1</xref>]. Ein Drittel der HS Patienten gibt eine positive Familienanamnese an und die Erkrankung weist einen autosomal-dominanten Erbgang auf. Zu den häufigsten Komorbiditäten der HS gehören unter anderem Morbus Crohn, Colitis ulcerosa, Spondylarthropathie und metabolisches Syndrom [<xref ref-type="bibr" rid="ref2">2</xref>]. Genetische Prädisposition, endokrinologische Störungen, dysregulierte erworbene Immunität, bakterielle Superinfektion, Rauchen und Adipositas gehören zu den begünstigenden Faktoren [<xref ref-type="bibr" rid="ref1">1</xref>]. Eine begrenzte Anzahl von Studien hat sich auf die Analyse molekularer Profiländerungen auf Gen- und/oder Proteinebene konzentriert [<xref ref-type="bibr" rid="ref3">3</xref>, <xref ref-type="bibr" rid="ref4">4</xref>]. Die betroffenen Signalwege sind hauptsächlich mit Inflammation assoziiert, einschließlich Zelladhäsion, Diapedese und Extravasation sowie Signal- und Kommunikationswegen für Immunzellen [<xref ref-type="bibr" rid="ref3">3</xref>]. Im Artikel von Constantinou, Fragoulis und Nikiphorou wird die aktuelle Evidenz zu Verbindungen zwischen HS und Autoimmun- und Infektionskrankheiten mit einem Schwerpunkt auf Epidemiologie und Pathophysiologie untersucht.
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Makrantonaki, Evgenia. "Hidradenitis suppurativa: Infektion, Autoimmunkrankheit oder beides?" Kompass Autoimmun 2, no. 4 (2020): 156–57. http://dx.doi.org/10.1159/000511302.
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Hidradenitis suppurativa (HS) ist eine chronisch entzündliche Hautkrankheit, die vorwiegend an Hautarealen auftritt, die viele apokrine Drüsen aufweisen, unter anderem im axillären, inguinalen, genitalen, und submammären Bereich. Die Prävalenz von HS zeigt eine signifikante Variabilität in epidemiologischen Studien und liegt zwischen 0,03% und 4%. Die Erkrankung tritt häufiger bei Frauen als bei Männern auf, Männer-Frauen Ratio 1:2 bis 1:5. Das durchschnittliche Alter bei Erstmanifestation liegt bei 23 Jahren [<xref ref-type="bibr" rid="ref1">1</xref>]. Ein Drittel der HS Patienten gibt eine positive Familienanamnese an und die Erkrankung weist einen autosomal-dominanten Erbgang auf. Zu den häufigsten Komorbiditäten der HS gehören unter anderem Morbus Crohn, Colitis ulcerosa, Spondylarthropathie und metabolisches Syndrom [<xref ref-type="bibr" rid="ref2">2</xref>]. Genetische Prädisposition, endokrinologische Störungen, dysregulierte erworbene Immunität, bakterielle Superinfektion, Rauchen und Adipositas gehören zu den begünstigenden Faktoren [<xref ref-type="bibr" rid="ref1">1</xref>]. Eine begrenzte Anzahl von Studien hat sich auf die Analyse molekularer Profiländerungen auf Gen- und/oder Proteinebene konzentriert [<xref ref-type="bibr" rid="ref3">3</xref>, <xref ref-type="bibr" rid="ref4">4</xref>]. Die betroffenen Signalwege sind hauptsächlich mit Inflammation assoziiert, einschließlich Zelladhäsion, Diapedese und Extravasation sowie Signal- und Kommunikationswegen für Immunzellen [<xref ref-type="bibr" rid="ref3">3</xref>]. Im Artikel von Constantinou, Fragoulis und Nikiphorou wird die aktuelle Evidenz zu Verbindungen zwischen HS und Autoimmun- und Infektionskrankheiten mit einem Schwerpunkt auf Epidemiologie und Pathophysiologie untersucht.
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Constantinou, Constantinos, Kenneth Widom, Joseph Desantis, and Melissa Obmann. "Hidradenitis Suppurativa Complicated by Squamous Cell Carcinoma." American Surgeon 74, no. 12 (December 2008): 1177–81. http://dx.doi.org/10.1177/000313480807401209.
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Hidradenitis suppurativa (HS) is a chronic inflammatory condition affecting the apocrine glands of the axilla, groin, and perianal region. Although it is a common condition, it is rarely associated with squamous cell carcinoma (SCC). There have been only 41 reports of this uncommon complication of HS in the literature. This study includes two uncommon presentations of HS associated with SCC along with a literature review. The first patient developed diffuse abdominal carcinomatosis from SCC in the anogenital region arising from HS. This is a rare event in patients with perianal SCC, with only one case previously described in the literature. The second patient developed malignant hypercalcemia, an uncommon complication of cutaneous SCC. The current report represents the largest review of the literature of patients with SCC secondary to longstanding HS. A recurrence rate of 48 per cent was observed after “curative” resection. Approximately half of the patients succumbed to their disease, and the grade of carcinoma was the only predictor of mortality. These two new cases underline the importance of close follow-up and aggressive management of patients with HS. Although the development of carcinoma is an uncommon event in HS, the consequences can be devastating with mortality approaching 50 per cent.
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Thompson, Alyssa M., Justine Seivright, Swetha Atluri, Amanda Ederle, Joanna Jaros, Jennifer L. Hsiao, and Vivian Y. Shi. "Radiotherapy for Hidradenitis Suppurativa: A Systematic Review." Dermatology 237, no. 3 (2021): 357–64. http://dx.doi.org/10.1159/000514027.
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<b><i>Background:</i></b> Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis characterized by painful nodules, abscesses, sinus tracts, and scarring mainly in the intertriginous areas. Patients with HS often experience inadequate responses to traditional treatment consisting of lifestyle modification, topical and systemic antibiotics, hormonal modulators, biologics, and procedural modalities. Low-dose radiotherapy has been used in benign cutaneous conditions, including HS; however, there is a paucity of literature summarizing its evidence. Herein, we systematically review the current literature on the efficacy of radiotherapy for patients with HS. <b><i>Summary:</i></b> This systematic review of the published literature reports the patient demographics, treatment regimens, efficacy, and adverse effects of radiotherapy in the treatment of HS. The historic timeline of these publications highlights the changes in management recommendations, introduction of more standardized outcome measures, and enhancements in treatment options. Radiotherapy appears to be an option for patients with treatment-resistant HS or who are poor surgical candidates. However, there remains a paucity of consensus on proper candidate selection, dosing, efficacy, and safety of the short- and long-term effects of radiotherapy.
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Głowaczewska, Amelia, Radomir Reszke, Jacek C. Szepietowski, and Łukasz Matusiak. "Indirect Self-Destructiveness in Hidradenitis Suppurativa Patients." Journal of Clinical Medicine 10, no. 18 (September 16, 2021): 4194. http://dx.doi.org/10.3390/jcm10184194.
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Hidradenitis suppurativa (HS) is a chronic, debilitating skin condition that negatively affects patients’ quality of life. Indirect self-destructiveness refers to activities extended over time, such as addictions, risky behaviors, neglects, resignation, helplessness. These can be an additional factor impeding the achievement of positive clinical effects in the treatment of HS patients, therefore the objective of the study was to assess the indirect self-destructive behaviors in patients suffering from HS. The study group involved 100 adult HS patients with 59 males and 41 females. Indirect self-destructiveness was investigated with the Polish version of the Kelley’s Indirect Self-Destructiveness Scale (CS-DS). The study revealed that the average total score of indirect self-destructiveness in HS population was 130.16 ± 21.3 (median 128 points). The CS-DS scores were significantly higher in smoking patents (p = 0.006). The most expressed class of indirect self-destructiveness was A5 (Helplessness and Passivity). The indicated results pointed out a strong domination of passive forms of indirect self-destructiveness over its active forms. Due to related low self-esteem, social isolation and exclusion, HS patients are more prone to behave in a self-destructive manner, which may lead to poor health maintenance in a form of leaving appointments and non-adherence.
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Kok, K., and A. Lahiri. "Penile degloving: an unusual presentation of hidradenitis suppurativa." Annals of The Royal College of Surgeons of England 94, no. 2 (March 2012): e101-e102. http://dx.doi.org/10.1308/003588412x13171221589252.
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Chronic hidradenitis suppurativa (HS) can cause lymphoedema, leading to novel presentations. We present the case of a man with chronic HS causing penile oedema and subsequent degloving. He underwent direct excision with a good result. Chronic HS patients should be warned about problems related to lymphoedema and reviewed regularly to resolve problems early.
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Sotoodian, Bahman, Mariam Abbas, and Alain Brassard. "Hidradenitis Suppurativa and the Association With Hematological Malignancies." Journal of Cutaneous Medicine and Surgery 21, no. 2 (September 22, 2016): 158–61. http://dx.doi.org/10.1177/1203475416668161.
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Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease affecting skin sites with a high density of apocrine glands. HS commonly presents after puberty, with most patients diagnosed in the second decade of their life. Several studies have investigated smoking, obesity, hypertension, diabetes, and dyslipidemia as possible underlying risk factors for HS. However, we encountered 2 patients with a long-standing history of untreated leukemia who developed late-onset HS. Objective: To investigate the presence of malignancy as an underlying risk factor for development of HS. Method: The PubMed and Scopus databases were searched for keywords such as hidradenitis suppurativa, malignancy, cancer, and epidemiology. Observation: Only 1 retrospective Swedish study with 2119 patients investigated the prevalence of cancer, including 6 hematopoietic malignancies, in HS patients. However, the study did not assess the timeline of developing HS in relation to the cancer diagnosis. We report 2 patients with a long-standing history of hematopoietic cancers who received no continuous treatments for their malignancies and developed late-onset HS: a 60-year-old male patient with hairy cell leukemia and a 68-year-old male patient with chronic lymphocytic leukemia who developed HS later in life. Conclusion: Multiple epidemiologic studies found the average age of HS diagnosis to be well prior to the fourth decade of life. The latency of the HS diagnosis as well as the presence of long-standing leukemia in both of our patients raises the necessity for assessing the possibility of malignancy, especially hematopoietic cancer, as a risk factor for HS. Limitation: This is a small retrospective analysis including only 2 patients. Larger studies would better assess the role of malignancy, leukemia in particular, as a possible risk factor for development of HS.
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Darch, K. M., T. L. Holland, and L. J. Spelman. "Hidradenitis Suppurativa Recurrence in a Caesarean Scar." Case Reports in Obstetrics and Gynecology 2020 (June 3, 2020): 1–4. http://dx.doi.org/10.1155/2020/6283720.
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Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic, relapsing inflammatory skin condition characterised by the presence of painful nodules, abscesses, and sinus tracts or scarring. Affecting up to 4% of the population, it is not uncommon and is seen predominantly in females at a ratio of 3 : 1. HS carries a substantial burden for those who suffer from it, from the significant psychosocial impact, to the cost of the multitude of topical and systemic treatments which often do not successfully control its symptoms. In this case report, we discuss a 33-year-old female known to our clinic, who presented with a recurrence of her HS in a caesarean scar, with otherwise silent disease. From our review of the literature, this appears to be only the second case of recurrence of HS in a caesarean scar reported to date. With a predilection for females of reproductive ages, involvement of sensitive areas, and an average of greater than seven years from onset of symptoms until diagnosis, the ability to recognise HS and ensure referral for specialist management is essential for all who are regularly involved in the management of this patient group.
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Amat-Samaranch, Victoria, Eugènia Agut-Busquet, Eva Vilarrasa, and Lluís Puig. "New perspectives on the treatment of hidradenitis suppurativa." Therapeutic Advances in Chronic Disease 12 (January 2021): 204062232110559. http://dx.doi.org/10.1177/20406223211055920.
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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by the presence of painful nodules, abscesses, chronically draining fistulas, and scarring in apocrine gland-bearing areas of the body. The exact pathogenesis of HS is not yet well understood, but there is a consensus in considering HS a multifactorial disease with a genetic predisposition, an inflammatory dysregulation, and an influence of environmental modifying factors. Therapeutic approach of HS is challenging due to the wide clinical manifestations of the disease and the complex pathogenesis. This review describes evidence for effectiveness of current and emerging HS therapies. Topical therapy, systemic treatments, biological agents, surgery, and light therapy have been used for HS with variable results. Adalimumab is the only US Food and Drug Administration (FDA) approved biologic agent for moderate-to-severe HS, but new therapeutic options are being studied, targeting different specific cytokines involved in HS pathogenesis. Comparing treatment outcomes between therapies is difficult due to the lack of randomized controlled trials. Treatment strategy should be selected in concordance to disease severity and requires combination of treatments in most cases.
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Del Duca, Ester, Paola Morelli, Luigi Bennardo, Cosimo Di Raimondo, and Steven Paul Nisticò. "Cytokine Pathways and Investigational Target Therapies in Hidradenitis Suppurativa." International Journal of Molecular Sciences 21, no. 22 (November 10, 2020): 8436. http://dx.doi.org/10.3390/ijms21228436.
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Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting areas with a high density of apocrine glands and characterized by subcutaneous nodules that may evolve into fistulas with pus secretion. Methods: The aim of this review is to investigate all current knowledge on cytokine regulation in the pathogenesis of HS. A systematic literature research using the words “cytokine”, “interleukin”, “pathway”, and “hidradenitis suppurativa” was performed in PubMed/Medline and Scopus/Embase databases. A search of the clinicaltrials.gov website for interventional recruiting and completed trials including the term “hidradenitis suppurativa” was also performed up to August 2020. We will discuss the pathogenetic role of various cytokines in HS and potential therapeutic targets for this debilitating disease. Results: The pathophysiology underlying this complex condition has not been clearly defined. An upregulation of various cytokines, such as tumor necrosis factor alpha (TNF-α), interleukin (IL)-1, IL-17, IL-23, and other molecules seems to be related to this inflammatory condition. Various cells, such as lymphocytes T Helper 1 and 17 and keratinocytes seem to be involved in the genesis of this condition. Conclusions: Several future studies and clinical trials are necessary in order to have new knowledge about HS and to properly treat this complex condition.
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Caccavale, Stefano, Vittorio Tancredi, Maria Pia Boccellino, Graziella Babino, Elisabetta Fulgione, and Giuseppe Argenziano. "Hidradenitis Suppurativa Burdens on Mental Health: A Literature Review of Associated Psychiatric Disorders and Their Pathogenesis." Life 13, no. 1 (January 9, 2023): 189. http://dx.doi.org/10.3390/life13010189.
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Skin, mental health and the central nervous system (CNS) are connected by a deep link. It is not only the aesthetic and sometimes the disfiguring aspects of dermatological conditions that can cause a severe psychological burden; also, different studies have shown how chronic skin-inflammatory diseases may influence the activity of the CNS and vice versa. Moreover, the skin and brain share a common embryogenic origin. Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting the hair follicles of the apocrine regions. The main clinical features are nodules, abscesses, cysts, fistulae and disfiguring scars. Pain and stinking discharge from fistulae are often present. It is not surprising that the psychological burden associated with HS is frequently a challenge in dermatologists’ daily routines. Patients often suffer from depression and anxiety, but also from substance abuse, psychotic and bipolar disorders and an increased suicide risk. The aim of this article is to review the main psychiatric disorders associated with HS and their pathophysiology. Research on Pubmed was conducted with the key words Hidradenitis suppurativa, psychiatric, depression, anxiety, bipolar, schizophrenia, abuse, suicidal. A high incidence of psychiatric disorders has been described in HS compared to controls. Hidradenitis suppurativa is not a rare disease, and acknowledging the HS psychological burden, psychiatric-associated diseases and associated biomolecular pathways will help dermatologists to better care for their patients.
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Seivright, Justine R., Alyssa Thompson, Iltefat Hamzavi, Michelle A. Lowes, Martina Porter, Vivian Y. Shi, and Jennifer L. Hsiao. "Hidradenitis Suppurativa Specialty Clinics in the USA." Skin Appendage Disorders 7, no. 5 (2021): 359–62. http://dx.doi.org/10.1159/000516308.
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<b><i>Background:</i></b> Hidradenitis suppurativa (HS) is a complex disease that is optimally managed with specialized care. Data on HS specialty clinics (HSSCs) are lacking. <b><i>Methods:</i></b> HSSCs in the USA were identified on the HS Foundation website and analyzed for geographic location and clinic director demographics. <b><i>Results:</i></b> We identified 29 HSSCs in 16 states, an increase from 22 in 2019. Thirty-four states currently lack a HSSC; the Mountain West and East South Central regions of the USA are particularly affected. Among HSSC directors, the majority (93.3%) are dermatologists, with slightly more women (53.3%) than men (46.7%). Most (86.7%) have an academic affiliation, and the majority (60%) graduated from residency <10 years ago. All directors are involved in research, and over half of HSSCs serve as HS clinical trial sites. <b><i>Conclusions:</i></b> The number of HSSCs in the USA has been growing, yet there remains a dearth in certain regions. Given that HS is a disease with high unmet need and a rapidly evolving therapeutic landscape, we encourage the establishment of more HSSCs to improve access to specialized care.
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Vorčáková, Karolína, Anna Ballová, Matúš Madleňák, Martin Vorčák, and Juraj Péč. "Single center retrospective analysis of association of hidradenitis suppurativa and chronic infl ammatory bowel disease." Gastroenterologie a hepatologie 75, no. 5 (October 31, 2021): 438–43. http://dx.doi.org/10.48095/ccgh2021438.
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Summary: Introduction: Association between hidradenitis suppurativa (HS) and chronic inflammatory bowel disease (IBD) exists. Prevalence of IBD in patients with HS is not clear. The aim of this paper is to determine the prevalence of IBD in patients with HS, evaluate risk factors and possible phenotype of patients with HS and IBD. Methods: Single center retrospective analysis of 241 patients with HS was carried out and medical files were searched for inflammatory bowel disease accordingly. Epidemiologic data of HS were collected. Results: IBD had a prevalence of 5.8%. Out of this number 13 (92.9%) suffered from Crohn’s disease (CD) and 1 (7.1%) from ulcerative colitis (UC). Eight patients (57.1%) were referred to the dermatologist by gastroenterologist and in six patients (42.9%) history of IBD was detected by dermatologist during routine examination. Special phenotype of the disease associated with IBD was not confirmed. The study points out possible existence of common comorbidities and risk factors such as smoking and obesity. Discussion: Our study confirmed similar data like those available in literature, where strong association between CD and HS is present and weaker with UC and HS. Conclusion: The prevalence of IBD in HS patients (5.8%) however these patients do not have a distinct HS phenotype. Key words: hidradenitis suppurativa – chronic inflammatory bowel disease – Crohn’s disease – ulcerative colitis – comorbidities – association – risk factors
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Chernyshov, Pavel V., Andrew Y. Finlay, Lucia Tomas-Aragones, Francoise Poot, Francesca Sampogna, Servando E. Marron, Sergey V. Zemskov, et al. "Quality of Life in Hidradenitis Suppurativa: An Update." International Journal of Environmental Research and Public Health 18, no. 11 (June 6, 2021): 6131. http://dx.doi.org/10.3390/ijerph18116131.
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Knowledge on hidradenitis suppurativa/acne inversa (HS) is rapidly increasing. HS has a profound impact on patients and their family life. Several factors, such as comorbidities, unemployment and HS severity, make this impact even more severe. The most widely used instrument to measure this impact is the dermatology-specific DLQI. We also identified six HS-specific health-related quality of life (HRQoL) instruments. Of them, HIDRAdisk, HSIA, HiSQOL and HSQoL-24 are better validated but there is still lack of experience of its use. Several treatment methods showed positive effect on patients’ HRQoL. Surgery remains a method with a substantial positive effect on HRQoL. Several studies confirming a positive effect of adalimumab on the HRQoL of patients with HS were published during the last three years. Data on the influence of several other biologics on HRQoL of HS patients are controversial or based on studies with a small number of patients.
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Daxhelet, Mathilde, Mariano Suppa, Jonathan White, Farida Benhadou, Linnea Rishøj Thorlacius, Gregor B. E. Jemec, Véronique del Marmol, and Jean Revuz. "Proposed Definitions of Typical Lesions in Hidradenitis Suppurativa." Dermatology 236, no. 5 (2020): 431–38. http://dx.doi.org/10.1159/000507348.
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Background: Although not rare, hidradenitis suppurativa (HS) is often under-recognized by physicians. The diagnosis of HS is clinical via the recognition of lesions typical of the disease, but universally accepted definitions of these latter are currently lacking, which means that certain severity scores employed for HS classification/management are used differently by different physicians. Our aim was to develop a set of descriptive definitions and associated images of HS lesions, in order to enable doctors to better recognize and evaluate the disease. Methods: MEDLINE-available literature and dermatological textbooks on HS morphology were retrieved (January 1996 to February 2016). A preliminary set of definitions of HS typical lesions was created, including 10 terms. Each term was associated with a pathophysiological classification and an image. This preliminary set was shown during the 5th Conference of the European HS Foundation (EHSF). The physicians attending the event were invited to vote on each term and make comments via a voting sheet. Results: A total of 81 physicians answered the questionnaire. Their agreement/disagreement rates and comments were used to obtain a revised set of definitions and images. Pathophysiological classifications were dropped. Conclusion: A user-friendly set of definitions/images of HS typical lesions was proposed and will need to be validated by further studies. This set could ultimately serve as a tool to better recognize, score, and assess treatment efficacy.
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Eichelberger, Ashley, Melissa Butt, Colleen Silva, Aretha Mosley, and Joslyn Kirby. "Perceptions of Teledermatology among people with Hidradenitis Suppurativa." SKIN The Journal of Cutaneous Medicine 5, no. 1 (January 1, 2021): 19–21. http://dx.doi.org/10.25251/skin.5.1.4.
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Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory condition that requires frequent dermatology visits. Coronavirus disease (COVID-19) led to a shift in healthcare delivery to telemedicine. Teledermatology can be valuable for HS patients to decrease travel and wait times and improve patient access. However, we hypothesized that people with HS may have concerns or challenges participating in HS due to its frequent occurrence in sensitive or difficult-to-photograph locations. Methods: A cross-sectional survey was sent to patients with HS at one academic institution as well as leaders of three patient networks. Results: Survey responses were received from 149 patients. A total of 94.4% were willing to have an online appointment due to COVID-19, and 88.9% were willing to use teledermatology if COVID-19 had not happened. 32.3% of patients reported that they had ever missed an appointment not due to COVID-19. Discussion: Our findings support patient willingness to use teledermatology for treatment and management of their HS.
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Eichelberger, Ashley, Melissa Butt, Colleen Silva, Aretha Mosley, and Joslyn Kirby. "Perceptions of Teledermatology among people with Hidradenitis Suppurativa." SKIN The Journal of Cutaneous Medicine 5, no. 1 (January 1, 2021): 19–21. http://dx.doi.org/10.25251/skin.5.1.4.
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Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory condition that requires frequent dermatology visits. Coronavirus disease (COVID-19) led to a shift in healthcare delivery to telemedicine. Teledermatology can be valuable for HS patients to decrease travel and wait times and improve patient access. However, we hypothesized that people with HS may have concerns or challenges participating in HS due to its frequent occurrence in sensitive or difficult-to-photograph locations. Methods: A cross-sectional survey was sent to patients with HS at one academic institution as well as leaders of three patient networks. Results: Survey responses were received from 149 patients. A total of 94.4% were willing to have an online appointment due to COVID-19, and 88.9% were willing to use teledermatology if COVID-19 had not happened. 32.3% of patients reported that they had ever missed an appointment not due to COVID-19. Discussion: Our findings support patient willingness to use teledermatology for treatment and management of their HS.
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Harvin, Glenn, and George Kasarala. "Two Cases of Paradoxical Hidradenitis Suppurativa while on Adalimumab." Case Reports in Gastroenterology 10, no. 1 (May 4, 2016): 92–98. http://dx.doi.org/10.1159/000444442.
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Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease characterized by recurring abscesses, nodules, and fistulas predominantly in the groin and axillae. The association between HS and Crohn’s disease (CD) has been well documented. Tumor necrosis factor (TNF) inhibitors have shown to be effective in treating both HS and CD. We report 2 patients who developed HS while on TNF inhibitor treatment for CD.
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Sakya, Surav, David Hallan, Sage Gee, Monica Rizk, Justin Brooke, and Joslyn Kirby. "Top 100 Most Cited Articles on Hidradenitis Suppurativa." SKIN The Journal of Cutaneous Medicine 5, no. 3 (May 17, 2021): 265–73. http://dx.doi.org/10.25251/skin.5.3.7.
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Background: Hidradenitis Suppurativa (HS) is a chronic condition that requires prompt diagnosis and treatment. To date, no bibliometric analysis on HS exists. Analyzing the top 100 citations is important to understand the characteristics of the most influential studies in the HS research landscape, and to guide future research. Objective: To analyze the top 100 most cited articles on HS using bibliometric analysis. Methods: Searches within Scopus and Web of Science using "Hidradenitis Suppurativa" and "Acne Inversa" were conducted on May 14th, 2020. After excluding non-original articles, data for the top 100 articles were analyzed using R-studio and Bibliometrix. Five independent reviewers identified study topic and design. Results: The top 100 most cited articles on HS were published between 1982 and 2017 with an average of 128.3 citations. The top research topic and design were treatment (40 articles) and randomized controlled trials (9), respectively. 2011 had the highest number of publications (9), and the 2012 article by Gregor B. E. Jemec had the highest citations (439). These articles were from 14 different countries with the United States and Denmark as top countries. 27 journals published these articles with the British Journal of Dermatology (BJD) as the top journal. Denmark had the greatest outside country collaborations. Conclusions: The results of our study showed that HS research is steadily growing with greatest support from the BJD. There is a focus on treatments in HS research with the United States and European countries leading the way. However, greater worldwide research of HS is needed.
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Smith, Mallory K., Cynthia L. Nicholson, Angela Parks-Miller, and Iltefat H. Hamzavi. "Hidradenitis suppurativa: an update on connecting the tracts." F1000Research 6 (July 28, 2017): 1272. http://dx.doi.org/10.12688/f1000research.11337.1.
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Hidradenitis suppurativa (HS) is a devastating disease involving abscesses, sinus tracts, and inflammation classically affecting the axilla, groin, and/or anogenital region. Although the disease pathogenesis is not fully understood, recent advances suggest that HS pathology runs much deeper than the cutaneous manifestations. It is now believed that HS is a systemic inflammatory disease that gives rise to the characteristic cutaneous manifestations. This disease is problematic for both patients and physicians to manage because of a variety of diagnostic and management difficulties. This article seeks to provide updates on the current understanding of HS to increase awareness and improve management.
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Moloney, Suzanne. "The challenges of wound management for hidradenitis suppurativa." British Journal of Nursing 31, no. 4 (February 24, 2022): S34—S41. http://dx.doi.org/10.12968/bjon.2022.31.4.s34.
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Hidradenitis suppurativa (HS) is an under-reported, poorly understood and often mismanaged inflammatory skin condition that manifests itself as painful, inflamed areas or boils. Although blind at first, it develops into exuding lesions often with tracking sinuses, leaving painfully stretched and scarred skin. While advances have been made in surgical and pharmaceutical interventions to interrupt the disease and prevent infection, effective wound management, evidence and guidelines remain limited. This article describes the experiences of an HS sufferer, in her quest for a satisfactory and acceptable wound management solution. It is hoped that the author's criteria for the ideal wound management system for HS will be the starting point for discussion and development of sound HS wound care guidelines.
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Senthilnathan, Aditi, Sree S. Kolli, Leah A. Cardwell, Irma Richardson, Steven R. Feldman, and Rita O. Pichardo. "Validation of a Hidradenitis Suppurativa Self-Assessment Tool." Journal of Cutaneous Medicine and Surgery 23, no. 4 (March 22, 2019): 388–90. http://dx.doi.org/10.1177/1203475419839965.
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Background: Hidradenitis suppurativa (HS) is a debilitating dermatologic condition presenting with recurrent abscesses. While there are multiple scales to determine HS severity, none are designed for self-administration. A validated severity self-assessment tool may facilitate survey research and improve communication by allowing patients to objectively report their HS severity between clinic visits. Objectives: The purpose of this study was to assess a self-administered HS measure. Methods: An HS self-assessment tool (HSSA) with 10 photographs of different Hurley stages was developed. The tool was administered to patients diagnosed with HS who visited the Wake Forest Baptist Health dermatology clinic over a span of 2 months. Physician-administered Hurley stage was recorded to determine criterion validity. To assess test-retest reliability of the measure, patients completed the HSSA again at least 30 minutes after the first completion. Results: Twenty-four patients completed the measure, and 20 of these patients completed it twice. Agreement between physician-determined Hurley stage and self-determined Hurley stage was 66.7% with a weighted kappa of 0.57 (95% confidence interval [CI]: 0.30-0.84). The weighted kappa for agreement between patients’ initial and second completion of the HSSA was 0.81 (95% CI: 0.64-0.99). Conclusions: The self-administered measure provides moderate agreement with physician-determined Hurley stage and good test-retest reliability.
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Robinson, India, Gabriella Santa Lucia, Alex Ritter, John Plante, and Manuel Valdebran. "Hidradenitis suppurativa and bilateral interstitial keratitis: A case report." Our Dermatology Online 13, no. 2 (April 1, 2022): 172–74. http://dx.doi.org/10.7241/ourd.20222.13.
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Hidradenitis Suppurativa (HS) is a chronic inflammatory disease that cause painful abscess and nodules in skin that contain apocrine glands. While HS has known associations with several inflammatory disorders, a rare association is interstitial keratitis. We present a case of bilateral interstitial keratitis attributed to a severe flare of HS disease resulting in systemic inflammation. Other case reports have established that bilateral interstitial keratitis can be attributed to HS, as well as other eye symptoms and diseases. Despite the rarity of keratitis in patients with HS, clinicians should be aware that this association does exist when their HS patient presents with severe or atypical eye symptoms.
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Savage, Kevin T., Kelsey S. Flood, Martina L. Porter, and Alexa B. Kimball. "TNF-α inhibitors in the treatment of hidradenitis suppurativa." Therapeutic Advances in Chronic Disease 10 (January 2019): 204062231985164. http://dx.doi.org/10.1177/2040622319851640.
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Hidradenitis suppurativa (HS) is a complex disease with a dramatic impact on the quality of life of patients that it afflicts. Despite this, there are few treatment options offering long-term relief. The exact pathophysiology of HS is unclear, although the current theory involves follicular obstruction, rupture, and subsequent inflammation leading to fistula and abscess development in intertriginous skin. Several inflammatory modulators have been implicated in the development of HS, including tumor necrosis factor (TNF)-α as well as interleukin (IL)-1β, IL-10, and IL-17. Initial evidence for the use of TNF-α inhibitors in HS stemmed from recognition that inflammatory bowel disease patients treated with these medications saw a concurrent improvement in their HS symptoms. Early case reports and case series illustrated TNF-α inhibitors’ value in the treatment of HS. Later, two phase III clinical trials, PIONEER I and PIONEER II, demonstrated that adalimumab is an efficacious treatment for HS. Infliximab represents another effective HS treatment option with its main advantage being dosing flexibility. In contrast, clinical trials have failed to show evidence for application of etanercept in HS. There is limited data on other TNF-α inhibitors such as certolizumab-pegol and golimumab. This review outlines the history, dosing, response, and adverse effects of TNF-α inhibitors in the treatment of HS.
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Mintoff, Dillon, Isabella Borg, and Nikolai Paul Pace. "The Clinical Relevance of the Microbiome in Hidradenitis Suppurativa: A Systematic Review." Vaccines 9, no. 10 (September 25, 2021): 1076. http://dx.doi.org/10.3390/vaccines9101076.
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Hidradenitis suppurativa is a chronic disease of the pilosebaceous unit. The name of the condition is a testament to the presumed relationship between the disease and the microbiome. The pathophysiology of hidradenitis suppurativa is, however, complex and believed to be the product of a multifactorial interplay between the interfollicular epithelium, pilosebaceous unit, microbiome, as well as genetic and environmental factors. In this review we assimilate the existing literature regarding the role played by the human microbiome in HS in various contexts of the disease, including the pathophysiologic, therapeutic, and potentially, diagnostic as well prognostic. In conclusion, the role played by the microbiome in HS is extensive and relevant and can have bench-to-bedside applications.
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Ghias, Mondana, Sophie Cameron, Fiona Shaw, Yssra Soliman, Allison Kutner, Mark Chaitowitz, Steven Cohen, and Morayma Reyes Gil. "Anemia in Hidradenitis Suppurativa, Hepcidin as a Diagnostic Tool." American Journal of Clinical Pathology 152, Supplement_1 (September 11, 2019): S15. http://dx.doi.org/10.1093/ajcp/aqz112.029.
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Abstract Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent nodules, abscesses, and dermal tracts. We recently reported a high prevalence of anemia in HS patients. These data led to the hypothesis that chronic inflammation in HS predominantly causes anemia of chronic disease (ACD) through upregulation of IL-6 and hepcidin, a key regulator of iron homeostasis. Hepcidin is widely accepted as a marker distinguishing ACD from iron deficiency anemia (IDA) in inflammatory conditions. The purpose of this study was to measure serum hepcidin in HS patients to classify the type of anemia observed in this cohort. We measured hematologic data, inflammatory markers, and serum hepcidin using an enzyme-linked immunosorbent assay (ELISA; R&D Systems) in 55 patients with varying degrees of HS severity. Independent Student t tests and one-way ANOVA were used to compare hepcidin levels in HS patients with anemic and nonanemic states. Of 55 HS patients evaluated in this study, 42 (76%) were female and the average age was 37.6 ± 13.2 years. The mean hemoglobin (Hb) was 12.2 ± 2.0 g/dL and mean hepcidin was 19.5 ± 12.9 ng/mL. Anemic patients (n = 26) with reduced iron stores (ferritin ≤30 ng/mL) had significantly lower hepcidin than anemic patients with adequate iron stores (9.7 ± 15.8 ng/mL vs 23.8 ± 11.1, P = .03). Elevated hepcidin in this subset suggests that ACD is the predominant cause of anemia. Analysis by ANOVA also found that hepcidin levels were significantly greater in patients with more severe HS, as measured by HS-Physician Global Assessment scores (P = .005). Hepcidin may serve as a surrogate biomarker for active disease and inflammation in HS. These findings affirm the utility of hepcidin as a promising tool for distinguishing IDA from ACD and, in turn, help identify HS patients in whom dietary iron supplementation is unlikely to be beneficial.
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De, Devea, Terri Shih, Swetha Atluri, Denise Fixsen, Brindley Brooks, Jennifer Hsiao, and Vivian Shi. "Support Group Utilization and Perspectives Among Hidradenitis Suppurativa Patients." SKIN The Journal of Cutaneous Medicine 6, no. 6 (November 16, 2022): 507–10. http://dx.doi.org/10.25251/skin.6.6.8.
Full textAbstract:
Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis associated with significant psychosocial burden. HS patients are more likely to experience mental health comorbidities such as depression and anxiety. They may also experience isolation due to fear of stigmatization as HS lesions are often associated with pain, scarring, and odor. This study investigates the perspectives of HS patients on HS support groups and the usage of this resource among this population. Methods: An anonymous Redcap survey was utilized via online social media HS support groups between 10/2021-1/2022 to collect demographic, usage, and perspective data. Comparative statistics were conducted and p-value of <0.05 was considered significant. Results: Of the 166 respondents, 78% respondents were part of an HS support group however, only 12% of respondents were recommended to join by their main HS healthcare provider and most (68%) learned about support groups through their own internet searches. Most respondents were daily (42%) and weekly (38%) support group users. Virtual meetings were preferred by the majority compared to in person meetings (50% vs 13%). The top reasons respondents reported attending support groups were to better understand HS, increasing their knowledge of HS resources, and access to treatment/care tips. Respondents without dermatologists as their main HCP and skin of color (SOC) respondents were more likely to report that support groups improved their care of HS (4.29 vs 3.90, p=0.031). Conclusion: Our findings highlight the preferential format of virtual support groups and that support groups may be an underutilized resource by healthcare providers for their patients. Support groups may help to narrow gaps in education when patients are unable to access or have delays in obtaining dermatological care, especially in SOC patients who have historically experienced higher rates of healthcare disparities.
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Bettoli, Vincenzo, Natale Schettini, Marco Libanore, Valeria Scuderi, Pierantonia Zedde, Riccardo Forconi, Lucrezia Pacetti, et al. "The Association among Pyoderma Gangrenosum, Ulcerative Colitis, and Hidradenitis Suppurativa and the Syndromic Hidradenitis Suppurativa Network: A Case Report." Skin Appendage Disorders 7, no. 3 (2021): 227–30. http://dx.doi.org/10.1159/000513639.
Full textAbstract:
Hidradenitis suppurativa (HS), together with other inflammatory diseases, is involved in a syndromic network where different combinations of signs and symptoms characterize the definition. The observation of the concurrent occurrence of HS, pyoderma gangrenosum (PG), and inflammatory bowel disease (IBD), in detail ulcerative colitis (UC), led the authors to describe a new association. The patient, a 36-year-old woman, who saw IBD as the first appearing condition, shortly followed by HS and PG, was referred because of a clinical situation quickly worsening. A severe aggravation of both GI symptoms and general systemic situation total led to total colectomy. Surprisingly, shortly after the radical surgical treatment of UC, the cutaneous manifestations of HS and PG with no specific treatment almost completely disappeared suggesting the existence of a common etiopathogenetic mechanism and possibly an inductor role of UC on the other disorders. The presentation of this case offers the opportunity to deal with the fact that the resolution of one of the associated conditions may lead to the clearance of one or more of the others. It confirms a pathogenetic link between them and the pivotal role of one of them, in this case colitis.
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Markota Čagalj, Adela, Branka Marinović, and Zrinka Bukvić Mokos. "New and Emerging Targeted Therapies for Hidradenitis Suppurativa." International Journal of Molecular Sciences 23, no. 7 (March 29, 2022): 3753. http://dx.doi.org/10.3390/ijms23073753.
Full textAbstract:
Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease deriving from the hair follicles. The formation of inflammatory nodules, abscesses, fistulas, and sinus tracts is characterized by a large inflow of key pro-inflammatory mediators, such as IFN-γ, TNF-α, IL-1, IL-17, and IL-12/23. Adalimumab is currently the only Food and Drug Administration (FDA)- and European Medicines Agency (EMA)-approved biologic therapy for moderate to severe HS in adults and adolescents. However, the long-term effectiveness of this TNF-α inhibitor in HS patients has shown to be highly variable. This review aims to review the evidence for emerging therapies that target the main pro-inflammatory cytokines in HS pathogenesis. A review of the literature was conducted, using the PubMed and Google Scholar repositories, as well as Clinicaltrials.gov. Presently, the most promising biologics in phase III trials are anti-IL-17 antibodies, secukinumab, and bimekizumab. Furthermore, an anti-IL-1 biologic, bermekimab, is currently in phase II trials, and shows encouraging results. Overall, the clinical efficacies of all new targeted therapies published up to this point are limited. More studies need to be performed to clarify the precise molecular pathology, and assess the efficacy of biological therapies for HS.
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Shanmugam, Victoria K., Nadia Meher Zaman, Sean McNish, and Faye N. Hant. "Review of Current Immunologic Therapies for Hidradenitis Suppurativa." International Journal of Rheumatology 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/8018192.
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Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory disease of apocrine gland-bearing skin which affects approximately 1–4% of the population. The disease is more common in women and patients of African American descent and approximately one-third of patients report a family history. Obesity and smoking are known risk factors, but associations with other immune disorders, especially inflammatory bowel disease, are also recognized. The pathogenesis of HS is poorly understood and host innate or adaptive immune response, defective keratinocyte function, and the microbial environment in the hair follicle and apocrine gland have all been postulated to play a role in disease activity. While surgical interventions can be helpful to reduce disease burden, there is a high recurrence rate. Increasingly, data supports targeted immune therapy for HS, and longitudinal studies suggest benefit from these agents, both when used alone and as an adjunct to surgical treatments. The purpose of this review is to outline the current data supporting use of targeted immune therapy in HS management.
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Radice, Caterina, Mariarosaria Cozzolino, and Federico Marchetti. "Una ragazzina che suda pus: l’idrosadenite suppurativa." Medico e Bambino pagine elettroniche 24, no. 2 (February 28, 2021): 55–56. http://dx.doi.org/10.53126/mebxxiv055.
Full textAbstract:
Hidradenitis suppurativa (HS) is a chronic or recurrent autoinflammatory skin disease that affects apocrine gland-bearing regions. Typical lesions are nodules and abscesses that often result in sinus tracts and fistulas. The paper describes a case of recurrent inguinal HS in a 12-year-old girl with Down syndrome. A stable remission was achieved with a systemic corticosteroid therapy (prednisone).
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Zouboulis, Christos C., Hendrik Hansen, Raffaele Dante Caposiena Caro, Giovanni Damiani, Isabelle Delorme, José Carlos Pascual, Ziad Reguiai, Anastasia Trigoni, Eva Vilarrasa, and Fernando Alfageme Roldán. "Adalimumab Dose Intensification in Recalcitrant Hidradenitis Suppurativa/Acne Inversa." Dermatology 236, no. 1 (October 18, 2019): 25–30. http://dx.doi.org/10.1159/000503606.
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Background: Adalimumab is the only approved compound for the treatment of adult patients with moderate-to-severe hidradenitis suppurativa (HS) who did not respond to a systemic classical treatment. Despite its significant short- and long-term efficacy, a percentage of patients do not respond sufficiently. Moreover, some primary responders experience a response loss with time. Objective: To analyse the effectiveness of adalimumab dose intensification in HS patients. Methods: A case series of adalimumab 80 mg/week subcutaneously (s.c.) compassionate use in patients with HS, who did not respond sufficiently or in primary responders with progressive response loss to the registered adalimumab dose of 40 mg/week s.c. Patients were collected and evaluated retrospectively. Patients’ data were extracted from medical records. Results: The 14 patients collected were Caucasian with HS of Hurley stage II–III and moderate or severe International HS Severity Score System (IHS4) stage. Adalimumab dose intensification significantly improved IHS4 score, Pain Index, HS-Physician Global Assessment, pain, and Cardiff Dermatology Life Quality Index. Two young female patients with HS and Crohn’s disease developed psoriatic lesions during the treatment with adalimumab 80 mg/week s.c. Conclusion: An enhanced level of effectiveness was assessed in the majority of the HS patients treated with adalimumab dose intensification (80 mg/week s.c.). Larger studies are required to evaluate this observation.
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Tzur Bitan, Dana, Daniella Berzin, and Arnon Cohen. "Hidradenitis Suppurativa and Bipolar Disorders: A Population-Based Study." Dermatology 236, no. 4 (2020): 298–304. http://dx.doi.org/10.1159/000504535.
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Background: Psychological comorbidities have been reported in patients with hidradenitis suppurativa (HS), yet only a few studies have investigated the possible association between HS and severe psychiatric disorders. The current study aimed to assess the association between HS and bipolar disorder, a major, chronic, psychiatric disease. Methods: A nationwide, population-based study was performed utilizing data from the Clalit Health Services (CHS) database in Israel. The study included 4,191 HS patients and 20,941 age- and gender-matched controls. A multivariate binary logistic regression, adjusted for demographic and behavioral risk factors, was performed. Results: A higher proportion of bipolar disorders was found among HS patients compared to controls (0.7 vs. 0.1%, respectively). There was an increased proportion of active smokers among HS patients than among controls (53.4 vs. 13.5%, respectively). In the multivariate analysis, adjusting for age, sex, and smoking, HS was found to be independently and positively associated with bipolar disorders (OR 2.12, 95% CI 1.21–3.27, p < 0.01), yet after controlling for body mass this association became nonsignificant. Conclusions: Bipolar disorders are associated with HS. Future studies should explore whether cardiometabolic deficiencies might account for this association. Healthcare providers should consider this potential co-occurrence as it may impede patient compliance and require appropriate screening and treatment. Results also stress the need for a multidisciplinary approach to optimize management of the disease and its associated comorbidities.
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Romaní, Jorge, Eva Vilarrasa, Antonio Martorell, Irene Fuertes, Cristina Ciudad, and Alejandro Molina-Leyva. "Ustekinumab with Intravenous Infusion: Results in Hidradenitis Suppurativa." Dermatology 236, no. 1 (July 9, 2019): 21–24. http://dx.doi.org/10.1159/000501075.
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Adalimumab is the only approved biological therapy for hidradenitis suppurativa (HS). The last published recommendations support the use of other off-label biologic therapies. We report on a multicentric retrospective review of patients with HS treated with an ustekinumab dosing schedule of intravenous infusion adjusted by weight, followed by a subcutaneous maintenance dose of 90 mg every 8 weeks, as recently approved for Crohn’s disease. The minimal follow-up period required for inclusion was 16 weeks. A total of 14 patients from six hospitals were included. In 50% of the treated patients, therapeutic outcomes, measured by means of the Hidradenitis Suppurativa Clinical Response (HiSCR) and decrease of Dermatology Life Quality Index (DLQI) and visual analog scale (VAS) of pain, were reached at week 16. In 71.42% of patients DLQI and VAS of pain improved, irrespective of achievement of HiSCR. Two patients abandoned treatment due to lack of efficacy or patient preferences. No ustekinumab-related adverse effects were reported. The results are limited by the retrospective nature of the study, the short follow-up period, and the small patient number. This therapeutic regime proved to be safe and showed moderate efficacy in treating HS with failure to previous biologic therapy. Ideally, the efficacy of ustekinumab in HS should be tested in randomized and controlled clinical trials.
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Sisic, Mia, Joslyn S. Kirby, Sanwarjit Boyal, Lisa Plant, Chelsea McLellan, and Jerry Tan. "Development of a Quality-of-Life Measure for Hidradenitis Suppurativa." Journal of Cutaneous Medicine and Surgery 21, no. 2 (November 12, 2016): 152–55. http://dx.doi.org/10.1177/1203475416677721.
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Background: Hidradenitis suppurativa (HS) is a chronic skin disorder with adverse impacts on both physical and psychosocial well-being. There is presently no validated HS-specific quality-of-life (QoL) measure. Objective: The objective of this study is to develop a QoL instrument for HS (HS-QoL) in accordance with recommended standards. Methods: Patient interviews (concept elicitation) and expert input were used to develop the conceptual framework for outcomes perceived important to patients with HS. A HS-QoL-v1 measure was developed, and cognitive interviews with patients were conducted for pilot testing. Results: Concept elicitation interviews with patients with HS (n = 21) generated 12 themes. Most frequently reported were impacts on daily activities and symptoms due to HS. These themes, along with literature review and input from clinical experts, informed development of the HS-QoL-v1. Nine cognitive interviews were conducted in a pilot test and resulted in the HS-QoL-v2 measure. Conclusion: The HS-QoL-v2 is a preliminary QoL instrument for which further psychometric validation and establishment of clinimetric properties will be undertaken.